Influencing factors of invasive adenocarcinoma in patients with pulmonary pure ground glass nodules on CT
LIAO Jianyong1, DU Jingbo, LIU Yingxin1, GOU Zhenheng1, SU Xiaohua1, CHEN Tianjin2
1. Department of Radiology, Daxing Teaching Hospital of Capital Medical University, Beijing 102600, China; 2. Beijing Municipal Corps Hospital of Chinese People's Armed Police Force, Beijing 100027, China
Abstract：Objective To investigate the influencing factors of invasive adenocarcinoma (IA) in patients with pulmonary pure ground glass nodules (pGGNs) on CT. Methods The clinical data and imaging features of 81 cases of pulmonary pGGN patients confirmed by surgical pathology in our hospital were analyzed retrospectively. These patients were divided into the IA group (43 cases) and non-IA group (38 cases). The maximum diameter and CT value were subjected to the receiver operational characteristic (ROC) curve analysis. The difference in clinical and CT features between the two groups was compared,and risk factors for IA were screened with logistic regression analysis. Results The ROC curve showed that the diagnostic threshold for predicting IA was 15.5 mm in maximum diameter and -575 Hu in CT value respectively. The diagnostic value of the maximum diameter (AUC=0.897) was higher than that of the CT value (AUC=0.701), and the combined use of the two was more effective. Between the IA group and non-IA group, there were significant differences in the maximum diameter, CT value, spiculation, lobulated-margin, bubble lucency and vascular convergence. No difference was found in gender, age, locations, pleural indentation, air bronchogram, or the vessel through sign and lung-tumor boundary. Logistic regression analysis showed that spiculation,a maximum diameter≥15.5 mm and CT value≥-575 Hu were risk factors for IA. Conclusions The features of pGGN IA mainly manifest themselves as spiculation, lobulated-margin, bubble lucency and vascular convergence. The pGGN with a maximum diameter≥15.5 mm, CT value≥-575 Hu, and presence of spiculation suggests that it is IA.
Chang B, Hwang J H, Choi Y H, et al. Natural history of pure ground-glass opacity lung nodules detected by low-dose CT scan[J]. Chest,2013,143(1):172-178.
2020, Vol. 31 
